Abstract
Introduction Proton pump inhibitors (PPIs) are used as prophylaxis, guarding against anastomotic
stricture (AS) in the aftermath of reconstructed esophageal atresia (EA). The incidence
of stricture formation was studied in this setting, comparing outcomes of 3- and 12-month
PPI prophylactic regimens.
Patients and Methods Patient characteristics (gestational age, birth weight, prevalence of chromosomal
aberrations, and other malformations), as well as rates of survival, AS formation,
and required balloon dilation, were recorded in the following therapeutic subsets:
(1) all infants undergoing primary surgical anastomosis for EA in years 2010–2014
and given postoperative PPI prophylaxis for 12 months and (2) all infants similarly
treated for EA in years 2001–2009 but given postoperative PPI prophylaxis for 3 months
only. Duration of follow-up was 1 year in each group.
Results Patient characteristics and survival rates in 12-month (n = 33) and in 3-month (n = 30) treatment groups did not differ significantly. The prevalence of AS was 42%/43%
in each group (12 months, 14/33; 3 months, 13/30; p = 1). Median number of dilations required was 3 (range, 1–9) per patient in each
group (p = 0.69). Median age at initial dilation was 163 days and 63 days in 12- and 3-month
groups, respectively (p = 0.04).
Conclusion Development of AS in the first year after reconstruction of EA was not reduced by
prolonged PPI prophylaxis (12 vs. 3 months), but initial balloon dilation procedures
were performed later in infants who were treated longer.
Keywords
esophageal atresia - anastomotic stricture - prophylactic proton pump inhibitor treatment
- balloon dilation
